University College Dublin Fieldwork Risk Assessment Template Persons completing this assessment should refer to the UCD Fieldwork Safety Manual 1. General Information Name of Person(s) nominated as Fieldwork Leader and their position Principal Investigator / Supervisor / Head of School or Unit (Person responsible for ensuring safety) Name(s) of other staff members attending and their position Details of fieldwork participants i.e. undergraduate students; postgraduate researchers; etc. Date of Assessment Duration and Frequency of fieldwork (Please provide date or range of dates of fieldwork) Location of fieldwork Please see Appendix 1 for Attendance sheet and Next-of-Kin details required for each participant, including fieldwork leader(s). 2. Title and Details of the Proposed Fieldwork - Provide details of fieldwork objectives, activities, equipment used, location, transport arrangements, third party requirements, site owner details, etc. Attach additional information, drawings, maps, permits, etc. as required. Title of Fieldwork: Details: UCD SIRC Office Rev 2. May 2015 Page 1 of 6 University College Dublin Fieldwork Risk Assessment Template 3. Hazard Identification and Risk Assessment Refer to the UCD Fieldwork Safety Manual for further detail To complete the Risk Assessment Form below: Identify the hazards in undertaking this fieldwork Evaluate the associated risks and consider who might be harmed and how, including any persons with health problems or lacking experience who may be at greater risk. List control measures to reduce the risk - procedures, equipment, training etc. Establish the residual risk rating after the implementation of controls Risk Rating = Likelihood of risk occurring x Severity of outcome Severity Likelihood Low Low Trivial Medium Acceptable High Moderate Medium Acceptable Moderate Substantial High Moderate Substantial Intolerable Assessment of Likelihood and Severity Low Medium High Severity of Outcome Slightly Harmful Harmful Very Harmful Likelihood of Exposure Unlikely Likely Very Likely 1. 2. 3. 4. Trivial Risk: No further action needed Acceptable Risk: No additional risk control measures required Moderate Risk: Implement further risk control measures if possible Substantial Risk: Further control measures must be implemented. If this is not possible then work must be strictly managed to ensure safety. 5. Intolerable: Work must be prohibited until further control measures are implemented. UCD SIRC Office Rev 2. May 2015 Page 2 of 6 University College Dublin Fieldwork Risk Assessment Template Hazard Risk(s) Control Measure(s) a. Physical hazards (e.g. extreme weather; mountains and cliffs, quarries, marshes; fresh or seawater) Residual Risk Rating: b. Biological hazards (e.g. poisonous plants; aggressive animals; insects, soil or water micro organisms) Residual Risk Rating: c. Chemical hazards (e.g. pesticides; dusts; contaminated soils; chemicals brought into site) Residual Risk Rating: d. Man-made hazards (e.g. electrical equipment; vehicles, insecure buildings; slurry pits; power and pipelines) Residual Risk Rating: e. Personal safety (e.g. lone working, violence and aggression) Residual Risk Rating: UCD SIRC Office Rev 2. May 2015 Page 3 of 6 University College Dublin Fieldwork Risk Assessment Template Hazard Risk(s) Control Measure(s) f. Environmental impact (e.g. rubbish; pollution, extreme heat/ cold) Residual Risk Rating: g. Other hazards (e.g. manual handling, fatigue, etc.) Residual Risk Rating: 4. Additional Risk Control Measures Select as appropriate Yes No N/A a. Has adequate insurance been obtained (Incl. PL, equipment or travel)? Provide Details below b. Have suitable travel arrangements been made (incl. licensed drivers)? Provide Details below c. Has permission been obtained from landowner to work onsite? d. Has adequate documented training and information been given to all participants? e. Have next of kin details been obtained for all participants, including fieldwork leader(s)? (See Appendix 1) f. Has adequate provision been made for persons with health problems or any special requirements? Provide Details below g. Have adequate first aid provisions been made? Provide Details below UCD SIRC Office Rev 2. May 2015 Page 4 of 6 University College Dublin Fieldwork Risk Assessment Template h. Detail fieldwork emergency response plan, including emergency response contact numbers i. Detail all necessary safety and other equipment that must be carried by the expedition as a whole and by every individual, include clothing requirements 5. Sign off by Fieldwork Leader and Head of School/ Principal Investigator Is the risk rating acceptable: Yes No If yes sign and date below and ensure all risk control measures have been implemented. If no identify further control measures and reassess risk. If the risk cannot be reduced to an acceptable level then the process cannot be carried out. Is this work suitable for lone working: Yes No Signed: Date: Position: ________________ __________ ________________ Signed: Date: Position: ________________ ___________ ________________ This document must be signed by the person carrying out the assessment and their academic supervisor / manager / head of school(person responsible for ensuring safety). UCD SIRC Office Rev 2. May 2015 Page 5 of 6 University College Dublin Fieldwork Risk Assessment Template Appendix 1 – Attendance Sheet of all fieldwork participants Name Contact Details Next-of-Kin Name Next-of-Kin Contact Details 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. UCD SIRC Office Rev 2. May 2015 Page 6 of 6